(Philadelphia, PA) - A new study that appears in the June 2004 issue
of the Journal of Clinical Oncology shows that the life-expectancy
of patients with advanced stage lung cancer can be extended with the use
of photodynamic therapy, or PDT, in addition to surgical intervention.
Typically, advanced stage non-small cell lung cancer patients have a median
survival of 6-9 months when treated with the current standard of care,
chemotherapy alone. However, this same set of patients demonstrated a
median survival of more than 22 months when chemotherapy was combined
with surgery and intraoperative PDT, a new laser-based cancer treatment.
Joseph S. Friedberg, MD, Chief of Thoracic Surgery at
Presbyterian-University of Pennsylvania Medical Center, Stephen
Hahn, MD, Clinical Associate Professor of Radiation Therapy and
James P. Stevenson, MD, Assistant Professor of Medicine
are the co-investigators in this trial at the University of Pennsylvania
Medical Center.

“We consider these results preliminary but extremely encouraging.
We expected PDT to make a difference in the rate of local recurrence and
it has,” says Dr. Friedberg, “However, we did not anticipate
the dramatic increase in survival that we have observed. In addition to
the local control, there must be some sort of systemic immune response
that is contributing to the enhanced survival we are observing in these
patients with a very advanced form of the disease. We are exploring this
phenomenon at a number of levels and feel we may have stumbled upon the
makings of a new immunologic approach to treating patients with all stages
of lung cancer. It is an area of research about which we are very excited
and actively pursuing.”

In PDT, a nontoxic photosensitizing agent, Photofrin, is injected into
the blood stream and concentrates in cancer cells, allowing the cancer
to become very sensitive to light. Using a laser to shine light on these
cells results in a very effective mechanism for killing cancer cells.
The damage occurs only where the light is shined, limiting the harm to
healthy tissue. PDT has rarely been used in this way, combining it with
other treatment modalities, although it has been used by clinicians for
treating small, easily visualized tumors in the windpipe and esophagus.
Patients eligible for the treatment are those whose cancer has spread
within the chest cavity.

In the study, each patient is treated with chemotherapy until the cancer
stops responding, the normal course for this disease and the limitation
of chemotherapy alone. After it is confirmed that the cancer has not spread
beyond the chest cavity, the patient then receives Photofrin 24 hours
prior to surgery. During surgery, the cancer is removed, which may involve
excising all or part of the affected lung. Then, surgeons shine a laser
into the chest cavity, giving the appropriate dose of light in an effort
to kill any remaining microscopic tumor cells that remain after surgery.

It is known that surgery, without PDT, will almost certainly be accompanied
by a high rate of local recurrence, likely a result of the invisible remaining
disease being targeted with PDT. The treatment has proven very safe, largely
as a function of using a specially designed computer system to measure
and monitor the amount of laser light delivered at the time of treatment.

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